ABSTRACT
Background: Second-trimester abortion is an important component of the comprehensive women’s health care. Data’s regarding second-trimester abortion is still under-reporting. Though the percentage of induced second-trimester abortion is low, its morbidity is higher than the first-trimester induced abortion. The abortion related mortality usually increases with the age of gestation.Methods: A retrospective observational study was conducted in the department of obstetrics and gynecology at Sree Balaji Medical College and Hospital, Chennai, over a period of one year. The data were collected from the medical case records and we have analyzed on the epidemiology, etiologies, complications and the methods of second- trimester abortion using statistical analysis.Results: In this study, there was no standard regimen of mifepristone and misoprostol were used for second-trimester abortion. The dosages were varied based on the gestational age of pregnancy. As the gestational age progresses, the amount of misoprostol required for the induction of second trimester abortion decreases and the difference is statistically significant. There was no reported case of rupture uterus, but varied complications such as post-abortal hemorrhage, retained placenta, need for blood transfusion, uterine perforation and one maternal death were reported during the study period.Conclusions: In order to reduce the morbidity and mortality of second trimester abortion, more policies and monitored services have to be rendered by the health system. Data regarding the second trimester abortion have to be improved.
ABSTRACT
Background: Health and family welfare of Indian Ministry, emphasis on postpartum IUCD insertion. Here we conducted a clinical study comparing intra-caesarean and interval CuT-380A insertion in caesarean deliveries.Methods: A systematic study with 150 patients in each group, recruited clients alternately. Group A Intra-Caesarean Cu-T insertion and Group B Interval Cu-T insertion in caesarean deliveries. Groups were followed up at 6th week and 6th month post insertion with a set of parameters. Missed strings, expulsion and infection rates were the primary outcome measures.Results: Infection rate is higher in Group A (2.3%) at 6th week, and at 6th month infection rate is higher in Group B (1.8%). Missed strings are higher in intra-caesarean than in interval insertion method both at 6th week and 6th month follow up p=0.000, hence significant. Expulsion rate is higher in Group A (2.5%) at 6th week, and at 6th month expulsion rate is higher in Group B (1.9%). There are no complications such as uterine perforation or contraceptive failures in both the groups during the study period. By analysis, there are no significant differences in infection and expulsion rates between the groups. For missed strings there is significant difference between the groups with more missed strings in intra-caesarean insertion method.Conclusions: To conclude, intra-caesarean method is equally effective as interval IUCD insertion method without added complications in caesarean deliveries, with advantage of high motivation, good compliance, safety and ease for the provider to deliver services.